[Intraoperative evaluation of the microcirculatory system in cardiosurgical patients]

The investigation was undertaken to study the specific features of vessels of the microcirculatory bed in cardiosurgical patients during myocardial revascularization. The study covered 20 patients with NYHA Functional Classes III-IV coronary heart disease. Ten patients from Group 1 were operated on the working heart (aortocoronary bypass surgery (ACBS) without extracorporeal circulation (EC)). In 10 patients from Group 2, myocardial revascularization was performed under normothermal (tcenter = 36 degrees C) EC (ACBS + EC). Microcirculatory blood flow was analyzed by laser Doppler fluometry. Microcirculatory blood flow index, variation coefficient, neurogenic and myogenic microvascular tone indices, and bypass value were estimated. It has been concluded that 1) laser Doppler fluometry evaluates the microcirculatory bed during anesthesia in cardiosurgical patients; 2) a dynamic response of the microcirculatory bed to stresses is retained during general anesthesia; 3) under normothermal EC, there are more pronounced microcirculatory disorders than during myocardial revascularization on the working heart.